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Category: Cadaver Use Committee

Many of us in HAPS have been fortunate to have learned human anatomy either by dissecting human specimens or by working with already dissected bodies. Many of us now teach students using human cadavers as the primary specimens for study in the lab. Beyond that, the anatomical knowledge of the general population results from investigations performed on dissected humans in the past. How many of us have ever considered where the dissected bodies came from? Probably very few; many of us can take for granted the present level of anatomical knowledge. Where these long-gone anatomists obtained their specimens never enters our conscious thought.

Early Asian anatomical art

There is a rich history of human dissection dating back to before the start of the Christian era. There are references to human dissection, cadaver investigation, or funerary practices in Egypt, Persia, Babylonia and India that extend back in time over four thousand years. Even then a pattern emerges indicating that those with the least and those guilty of crimes bore the burden of serving as specimens for dissection. There was even a brief period shortly before the Christian era during which human vivisection was practiced on criminals in Egypt.

Over the span of time, bodies have come from multiple sources including debtors, societal outcasts, the mentally ill and strangers, recent unclaimed dead, anatomical oddities and even victims murdered specifically to serve as dissection specimens. Bodies obtained by “entrepreneur” grave robbers throughout the Renaissance and continuing well into the nineteenth century in Europe and America were the primary supply of bodies for dissection, with bodies stolen from the easily accessed burial sites used by families with few or no real financial assets, and rarely if ever from the much more secure cemeteries of the rich and privileged.

Death mask cast of William Burke and a pocket book made from his skin; Burke was executed in 1828 for murdering people and delivering their bodies to medical school in Edinburgh.

During the nineteenth century in Europe, donation of bodies by family members became legal as a way for the poor to eliminate funeral expenses. In Tasmania, genocide of the aboriginal population in less than a century largely benefited bone collectors back in England. In America, a booming business in the bodies of African slaves and freeborn blacks signaled another low point in this narrative.

Finally, the successful heart transplant performed in 1967 by Dr. Christian Barnard in South Africa triggered an increased interest in organ transplantation and the importance of organ and body donations. The result was the passage of the first Uniform Anatomic Gift Act in 1968, creating a sustainable system based largely on altruism to provide for both the needs of the transplant community and those of anatomy and medical education.

Hopefully this narrative that chronicles the thoughtless and often diabolical events of the past will spur those of us involved in anatomy and medical education to consider and appreciate the unwilling sacrifices of so many in the past that made the current state of anatomic knowledge possible. As educators, we should play a role in acknowledging, even briefly, this history to our students and the debt of gratitude we owe to so many who have been so wronged in the past.

Bill Perrotti is a HAPS President Emeritus and a professor at Pennsylvania State University.

During research for past HAPS workshops, I was struck by a shift in attitudes toward and uses for dissection in Europe. It was not always a practice banned by the church and practiced in secret as is often thought. There was a complex combination of factors that left medical men who conducted dissections in a constantly fluctuating position in the eyes of the public, as the use of the female body ranged from a righteous religious exploration to sexually charged education.

Vesalius’ dissection of a female (woodcut image from 1555)

The context of female dissection in particular has morphed through the centuries – in the Middle Ages the bodies of religious women were dissected to provide evidence of their holiness, and into the Renaissance patrician mothers would be dissected to provide familial medical information. Dissections were conducted to gain information about women who had value to their communities and families. During the 16th century, dissection became more associated with shame as the bodies of executed criminals were granted to medical men and made into public exhibitions.

As society came to view dissection as a punishment worse than execution itself, the public dissection of women became particularly horrifying. While fear of these punishments was intended to deter criminals, increased association of dissection with negative acts dovetailed with growing religious and social sentiments valuing the burial of a complete body. Condemned female criminals were rare compared to their male counterparts, partially due to a social bias against executing women. Legal avenues of witnessing the dissection of a female body were scarce.

Anatomical Wax of a female from La Specola in Italy.

Social mores also prevented most living women from being physically examined in detail, and training new medical men was difficult with a lack of female bodies, living or dead. This led to great creativity in generating alternatives. The 18th century produced a flurry of wax anatomical models, which allowed detailed portrayals of anatomy that could have been helpful in learning the minutiae of the body. The teaching value of these was only as good as the artist involved, however, and these models tended to be posed in ways that did not contribute specifically to their educational worth.

During the same time, midwifery manuals and anatomical atlases focusing on women were produced with illustrations of reproductive organs combining internal and external perspectives. One 19th century book included paper dolls with articulated joints that could be moved through a pop-up book-like model of the pelvic girdle just to make things a bit more interactive. As three dimensional models became more complex, gynecological models became particularly popular in the 19th century. They were supposed to allow the simulation of birth, and often came often with a matching fabric baby to manually pull through the birth canal.

And while some of the solutions developed to cope with the unavailability of female cadavers may seem odd today, they give us a wonderful window onto the social tug-of-war that occurred between decorum and the urge to know more about the female body!

Danielle Hanson teaches Human Anatomy and Physical Anthropology at several Indiana schools, and has a long held interest in the history of both fields. She has an MS in Anatomy Education, and is a Ph.D. Candidate in Physical Anthropology at Indiana University.

Eduard Pernkopf was a Nazi. That is the short of it. He also created an anatomical atlas that has become a notorious source of ethical debate since at least the 1990s.

So, who was Eduard Pernkopf?

Pernkopf was an Austrian medical doctor. During World War 1, he served as a military physician for Austria. After the war, he returned to the University of Vienna and became an Anatomy Instructor for the medical school. By 1928 he was a full professor and by 1933 he was the director of the anatomical institute. Also in 1933, Pernkopf pledged his allegiance to the Nazi party, later becoming a member of the Sturmabteilung, Hitler’s pre-war Stormtroopers.

In 1933, he also started work on his anatomical atlases. Four artists rendered watercolor portraits of his dissections, Pernkopf set out to create the most realistic representations of cadaveric dissections ever available with the caveat that the color be as realistic as possible. Two volumes ended up being published, one in 1937 and one in 1941. By 1941, all four of the artists joined active military or paramilitary service for Germany.

So, why is this atlas so controversial?

In 1938, Pernkopf became Dean of the medical college at the University of Vienna. He immediately expelled all non-Aryan professors; at Vienna, that meant over 75% of the faculty, several of whom would end up dying in concentration camps across occupied German territory. As Dean, Pernkopf enacted a strict racial hygiene approach to medicine. Across occupied Germany, medical schools were teaching that there were inferior anatomical characteristics of non-Aryans like Jews, Gypsies, Romani, and Poles, and homosexuals.

As a footnote to history, no one was forcing these scientists to go along with ideas like racial hygiene. In fact, it seems like the scientists were the driving force behind these ideas. Spurred on by eugenicists in the U.S., Nazi scientists were pushing hard for eugenics in Germany. This lead to forced sterilization, anti-miscegenation and anti-immigrant laws, and euthanasia. These were the three basic prongs of the Nazi Volksgesundheit, or Public Health. By 1934, forced sterilization turned to euthanasia of people deemed mentally feeble. Early euthanasia programs turned to Holocaust as Germans placed non-Aryans in concentration, work, and prison camps.

As you can imagine, a lot of dead bodies meant a steady supply of cadavers for teaching and research at the 31 German or German occupied medical schools in Europe. There is evidence that while Pernkopf was dean, the University of Vienna medical school accepted 1,377 executed prisoners. It was customary that the medical schools would have embalming centers at the execution sites so that cadaveric materials could stay as fresh as possible.

There is questionable imagery within the atlases; images of emaciated cadavers in poor condition. There is also Nazi imagery in the signatures of the artists.

So, we have a bunch of Nazis who were very racist and who used very questionable sources for dissection to make their controversial anatomical atlas.

But, Vienna was bombed by allied forces in 1945. The university sustained heavy damage and the records containing the information about where the bodies used for the atlas came from were destroyed.

Did he use executed prisoners or not? And what should we do about the book?

Come find out and discuss the answers to these questions at the workshop Pernkopf, NAZIs, and MVCC at the 2018 HAPS Conference in Columbus.

This post was written by Aaron Fried, Assistant Professor of Anatomy and Physiology at Mohawk Valley Community College. Thanks to my colleagues and willing editors: Shannon Crocker, Eileen Bush, Don Kelly, Bill Perrotti, Emeritis, and the late Sam Drogo.